DRIVING THE DAY: President Obama hosts a group of state insurance commissioners and insurance company CEOs at the White House today before his administration rolls out four new regs: a ban on pre-existing exclusions for children; a ban on rescissions except in cases of fraud; a ban on lifetime caps; and restrictions on annual limits.

It's Tuesday morning. “So you think you can Pulse me and spit in my eye?”

OBAMA'S MESSAGE — An administration source tells Pulse that the president “will make clear his firm commitment to ensuring that consumers are treated fairly throughout the implementation process – that includes looking at whether premium increases are reasonable and justified – and point to the significant action taking place across the country to ensure consumers are protected.”

WHAT TO WATCH — Today's W.H. event is a chance to take the temperature of the relationship between the administration and insurance companies ahead of what’s shaping up to be a big fall fight: who's to blame for insurance premium increases.

** A message from the Alliance of Specialty Medicine: The Alliance of Specialty Medicine represents the federal public policy interests of more than 100,000 specialists from across the country. Alliance members are highly skilled medical professionals who help make our nation’s health care the best in the world. Learn more at www.SpecialtyDocs.org. **

WHAT'S NEXT— The House returns to work today and has to figure out what to do with the Senate-passed, six-month SGR patch. Pelosi has already rejected it, but expect to hear a chorus of calls for the House to suck it up given all the trouble it took to get the bill through the Senate.

The president of the Military Officers Association of America, whose members’ TRICARE is linked to the Medicare payment formula, sent a letter Monday to every House member suggesting a quick vote. And an email went out to MOAA members asking them to lobby their lawmakers.

But hospital groups -- including AHA, AAMC, FAH, Catholic Health and National Association of Public Hospitals -- are angry that the “72-hour rule” was changed to pay for the patch, calling it “unfair and unwarranted” after the hits they're already going to take from reform.

SO, WHERE DO WE GO FROM HERE? — A House leadership aide tells Pulse: “We remain committed to ensuring that our seniors and veterans receive the care they deserve, and that is why the urgent jobs legislation we sent the Senate weeks ago included an 18-month Medicare physician payment extension. Senate Republicans blocked both the physician extension and the urgently needed jobs.”

THE BOTTOM LINE — Everyone expects the docs to get their retroactive patch, but no one seems ready to cave to do it.

EXIT STRATEGY — Pulse has learned that Abby Block, director of CMS’s Center for Beneficiary Choices, will leave the agency at the end of the month. From Block’s email: “I am excited about moving on to yet another new experience and looking forward to the challenge of working outside of the federal government.”

CBO: HIGH RISK FUNDING NOT "SUFFICIENT" — Without a cap on enrollments in the new, federally-funded high risk pools, "the available funds will probably be exhausted prior to 2013," according to a late Monday CBO letter to Sen. Mike Enzi. The news will compound fears that states will get stuck with an unfunded insurance program.

An administration official says: "HHS will be working with states to ensure these resources are used efficiently and effectively so that as many people as possible can get insurance through the temporary high-risk pool program." CBO letter

HHS WORKING "24/7" TO SET UP WEB PORTAL — HHS goes live with HealthCare.gov next Thursday. CTO Todd Park and a team of more than 20 HHS staffers are pulling extra shifts to open a resource-heavy, data-intensive site that will pull together information from dozens of private insurance companies, integrated with resources on public insurance programs.

LINK EARLY, LINK OFTEN— Most signs indicate that the portal will be incredibly link heavy, guiding consumers to outside resources rather than aggregating insurance info. Last week, OCIIO mailed letters to insurers letting them know if the links they provided were either "non-functioning, indirect or inaccurate" and instructing them to submit more accurate information. Letter

FEINSTEIN INTRODUCES RATE REVIEW BILL — Obama wanted the provision in the reform law but it had to be killed because it wouldn’t have survived reconciliation. Feinstein says that left HHS with "no authority to do anything about these rate increases. So an insurance company can argue that a large increase is justified, but in some states, there is no review to see that it is.”

THE GOP STANDS ALONE? — A group of influential medical groups -- AHA, AAMC, FAH, Catholic Hospitals, American Medical Rehabilitation Providers -- said Monday that they’re backing Dr. Berwick to lead CMS. “Dr. Berwick … will bring a wealth of knowledge and practical experience to CMS from his perspective as a physician, teacher and passionate advocate for high-quality care,” they wrote. AMA came out in support of Berwick soon after his nomination. And a group of 130 health organizations put out a letter last week. The letter

DeFundIt, the campaign to defund the reform law, is out with a new video backing Snooki and the “mom and pop” tanning salon owners that they say are hurt by the tax. Video

STATE SCAN:

CONNECTICUT JUMPS AHEAD — CMS on Monday gave Connecticut the OK to implement the reform law’s Medicaid expansion early. Connecticut estimates that 45,000 adults will become eligible for Medicaid with the move. “We hope other states will follow Connecticut’s example and not wait four years to provide health benefits to those who desperately need them,” said Marilyn Tavenner, acting administrator of CMS.

The early implementation essentially “saves” the state $53 million as it moves the people from a state-run assistance program onto federal Medicaid, according to the Hartford Courant. Story

REFORM SAVES MONEY IN HAWAII, MASS. — The most interesting tidbit from the Kaiser Commission on Medicaid and the Uninsured’s huge new Monday report: Two states will actually save money via the Medicaid expansion to up to 133 percent of the FPL. Massachusetts and Hawaii will spend a respective $1.2 billion and $28 million less on their Medicaid programs, while increasing their enrolments by 2 and 38 percent. What’s so special about these two states? Both qualified for higher Medicaid expansion match rates: Mass. because the state already covers childless adults with incomes above 133, Hawaii for a less extensive but still notable expansion of Medicare waivers. KFF report

BUT THEN THERE'S THIS — The Boston Globe’s Patrick Lee reports: “Senator John. F. Kerry, state leaders, and health care advocates met yesterday to discuss a new report that highlights the major differences between the federal and state health care models. The focus of the event quickly turned to the hurdles of implementation and the need to protect the gains Massachusetts has made since 2006, when the state embarked on a closely watched experiment to extend health insurance to virtually every resident. The report reveals that, despite the promised increase in federal funding, some Massachusetts residents might end up facing higher premiums.”

** A message from the Alliance of Specialty Medicine: Specialty-care doctors treat patients for problems their primary care physicians cannot fix. From head to toe, there is a specialist who can help you.

Senior citizens are among our nation’s most vulnerable populations and, often, they need the care and expertise only a specialist can give. So why is Congress playing with seniors’ health care?

The current Medicare sustained growth rate (SGR) – the federal government’s medical payment system for seniors - is out of date and has never truly reflected the actual costs of medical procedures. Now as patients’ needs become more complex and research, technology, and equipment becomes more specialized; the need for a more current reimbursement structure is needed.

Already, doctors provide care to many patients at a financial loss, however with the pending Medicare cuts and the coming increase in costs, soon senior citizens may be at risk of losing access to their doctor or specialist.

Congress needs to immediately pass a permanent Medicare payment fix that will provide seniors with the medical security they deserve.